Niloufer Khan, MD, MS
Niloufer Khan, MD, MS, Leverages Research to Lower Risks for Patients with Blood Cancers
Using support from a 2018 Young Investigator Award (YIA), Dr. Khan is exploring ways to prevent dangerous decreases in gut bacteria that can result from common blood cancer treatments.
Research Provides Gut Check for Patients with Blood Cancers
Having a healthy range of gut bacteria is necessary for regulating digestion and maintaining health, especially for patients with cancer. Certain cancer treatments can put patients with blood cancers at risk for dangerous decreases in their stomach bacteria. Unmanaged declines in the diversity of gut microbiota can be fatal.
Patients with lymphoma and multiple myeloma often require a heavy treatment regimen to reach cure or remission. However, high-dose chemotherapy or autologous hematopoietic cell transplantation (auto-HCT) – a type of bone marrow transplant – can decrease the diversity of gut microbiota. This exposes patients to increased risks of mortality or long-term complications.
Dr. Khan, a medical oncologist at the Memorial Sloan Kettering Cancer Center, is researching ways to prevent the decreases in microbiota diversity that can result from common blood cancer treatments.
"Although we are in the early stages of understanding how to intervene and target the microbiota, we do see that loss of microbial diversity and changes in gut bacterial composition may affect clinical outcomes," says Dr. Khan.
New Avenues for Care
Using support from a Conquer Cancer YIA, Dr. Khan analyzed data from an observational study of gut microbiota diversity and clinical outcomes in patients treated with auto-HCT. She found lower pre-transplant microbiota diversity in patients with cancer compared to people who do not have cancer. Diversity further decreased during and after bone marrow transplantation.
Dr. Khan's work suggests gut microbiota are key targets for clinical intervention in patients with blood cancers. Monitoring the diversity of gut microbiota could help doctors predict a patient's risk of death. More research may also enable scientists to build potentially life-saving strategies for helping patients maintain or increase the diversity of their gut microbiota. This could make treatment easier for patients.
"There's potential to develop low-cost interventions with low toxicities, like changing the antibiotics that are given to patients undergoing transplant," says Dr. Khan.
Another benefit of Dr. Khan's YIA research is that she's better equipped to answer questions from patients about how diet, nutrition, and gut health will affect them during and after treatment.
"I think patients are eager to do whatever they can to improve their own health and chances for success with cancer treatment and survivorship. The concept of microbiota or gut bacteria is specifically something which I think people are reading about and seeing in the media, so I think patients are curious about it," says Dr. Khan. "After completing my YIA-funded project, I'm able to share my results with patients and I also let them know this is an area of active study and investigation. I think patients are happy to know this, as it is an important question for them."
Future Research, Patients First
Dr. Khan's next step is to conduct a prospective clinical trial to validate the findings from her YIA-funded observational study. She also plans to measure how microbiota diversity changes in patients who are undergoing other treatments for blood cancers, like immunotherapy and targeted therapies.
"My research supports further, prospective exploration of targeted treatments to increase microbiota diversity and examine outcomes after auto-HCT, and our institution is actively pursuing these clinical trials," says Dr. Khan.
Helping patients live longer, happier and healthier lives is at the heart of all Dr. Khan does to conquer cancer.
"It's really a privilege to care for all of my patients and it is so rewarding to see them get good news at the end of treatment, to learn that their cancer has been treated, and to see them remain in remission," says Dr. Khan. "I especially enjoy discussing what their future will look like, and how we can help them return to as close to a normal life as possible."
After completing my YIA-funded project, I'm able to share my results with patients and I also let them know gut microbiota is an area of active study and investigation. I think patients are happy to know this, as it is an important question for them.